Neoadjuvant chemotherapy plus radical surgery is safe to treat cervical squamous cell carcinoma

In a prospective, randomized controlled study carried out by Huang Jing et al., the neoadjuvant chemotherapy exhibited low toxic adverse effects in patients with IB2/IIA2 stage cervical squamous cell carcinoma. Radical surgery after chemotherapy was found to be feasible and safe.

Investigators undertook the research to investigate the clinical outcomes of the combination of neoadjuvant chemotherapy and radical surgery in 68 people having locally advanced cervical squamous cell carcinoma.

Participants were randomized into either (i) Experimental group (35 participants): Received paclitaxel and cisplatin neoadjuvant chemotherapy for 2 cycles, then underwent bilateral adnexectomy and radical hysterectomy at two weeks after chemotherapy, and (ii) Control group (33 participants): Underwent radical hysterectomy and bilateral adnexectomy following cervical squamous cell carcinoma diagnosis.

For the experimental arm, the toxic and adverse effects of chemotherapy were examined. For both the arms, the blood loss, complications, operation method, grade of wound healing, operation time and postoperative pathology were assessed. The primary foci and pelvic lymph node recurrence and distant metastasis were noted, and estimation of three-year and five-year survival rates was done.

Only 1 participant in the experiment arm was found to have grade III bone marrow suppression. No other grade IV and III chemotherapy toxic reactions were noted. The surgery was successfully accomplished in all the participants. Both the groups displayed comparable pelvic drainage tube indwelling time, bladder injury, surgery time, postsurgery complications, ureteral catheter placement, metastatic ratio of lymph nodes, ureteric injury, postsurgery urinary tub, anal exhaust time, and intraoperative blood loss.

When compared to the control group, the experimental group revealed substantial differences in the number of dissected lymph nodes, vascular tumor emboli, and deep myometrial invasion. The 3-year and 5-year disease-free survival and overall survival were not substantially different between the two groups, as shown in Table 1:

Table 1: Disease-free survival and overall survival in the study groups

Neoadjuvant chemotherapy displays a coordinating role in minimizing the tumor infiltration depth of the deep muscle layer and the occurrence of vascular tumor emboli, decreasing the usage of postsurgery adjuvant therapy, and enhancing an individual’s quality of life. However, it does not offer a significant survival benefit, concluded the study authors.

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